state reportables

Nascar nurse, ASN, RN · Feb 12, 2009

You need to cure schizophrenia.. then it will never happen again PLUS you will be rich and famous and won't have to worry about it ever again (just in case it does happen). Tee hee.

Sorry, I have had a long day with surveyor over a state reportable myself. It was the best response I could come up with under the circumstances. Good luck.

CapeCodMermaid, RN · Feb 12, 2009

I don't understand what you mean by getting your reportables 'cleared'. A few times in the past, I've had the DPH call and ask for more information. Sometimes they come out to the facility, but lately they haven't come out for anything, including an allegation of abuse. I report everything but never send them more information than I have to.

achot chavi · Feb 12, 2009

1. NEVER ( and I mean NEVER) volunteer one word more than you have to- first lesson of surveys.

2. re the schizophrenic- don't you have a psychologist that cares for him and can take care of this for you?

3. Perhaps change the mans room? Can you do that without upsetting the SW?

GOOD LUCK!!

travel50 · Feb 12, 2009

You need to cure schizophrenia.. then it will never happen again PLUS you will be rich and famous and won't have to worry about it ever again (just in case it does happen). Tee hee.
Sorry, I have had a long day with surveyor over a state reportable myself. It was the best response I could come up with under the circumstances. Good luck.

Thanks, I needed the laugh!!! :lol2:

Capecod, I wish I didn't know anything about this!!!! I have to report any allegation of abuse or allegation of misappropriation of funds, any allegation, however unfounded, by an unhappy family member or visitor....any anything. When I put in the corrective action plan, the state person writes back and says I have to explain something or add something. I will have already put that in, so try to reword it. Matter of fact, on one I wrote word for word what is on their example, and they still rejected it. I called in total frustration earlier this week, and the only comment was that I had written too much. It didn't used to be this way. I don't know if it is the person now checking them or just new rules at the state level. The DONs in our sister facilities are also at their wits end over this.

travel50 · Feb 12, 2009

1. NEVER ( and I mean NEVER) volunteer one word more than you have to- first lesson of surveys.
2. re the schizophrenic- don't you have a psychologist that cares for him and can take care of this for you?
3. Perhaps change the mans room? Can you do that without upsetting the SW?
GOOD LUCK!!

1. Yes, I learned right away not to volunteer anything extra. When I first started as the ADON, the then DON volunteered something extra during survey and it netted her an IJ!!! But I have only put in the info they wrote back and told me to put in. Seems I was supposed to delete what I already had written, not add to it.

2. Yes, I have a nurse practitioner with psych services as well as a counselor. I'm not sure how they should take care of it, but they have tried. Meds have been adjusted, he has been sent out for treatment elsewhere, he has had innumerable counseling sessions, etc.

3. He is paranoid, but also with it enough to know exactly what he is doing. After he made the last round of allegations, he walked out of the SW's office, laughing and saying he enjoyed making that one up. My regional nurse consultant was there and said I had to do a state reportable anyway b/c he had made the allegation. Actually, I don't think I offered to change his room that time, but he changes rooms an average of once a month. He is unhappy with any roommate. He states that no matter who we put him with, he will make allegations b/c he wants a private room (which we don't have).

He also refuses to transfer elsewhere. Really we like him and would hate to send him away, but good grief!!! We didn't use to have to report things that were unfounded, and now that I am told I have to, it is a pain.

Thanks for the suggestions!

CapeCodMermaid, RN · Feb 12, 2009

Ah..I see. I was taught by the best how to write a reportable. The last year I think I sent in 25-30 and never got a call asking for more information. I tell the truth as I know it and so far so good!

travel50 · Feb 13, 2009

Ah..I see. I was taught by the best how to write a reportable. The last year I think I sent in 25-30 and never got a call asking for more information. I tell the truth as I know it and so far so good!

Oh, I am so jealous!!! I had exactly 1½ hours orientation for this job. I hadn't wanted the job, but have really tried to do the best I could with it. I do dearly love my residents, and my staff tries to be wonderful. I was the only person in house qualified to take the position when the previous DON had had enough. That was 3 yrs ago. We've had excellent surveys, doubled census, low turnover, etc. And the state reportable never used to be a problem. Since a new person started doing these reports from the state side, they are consistently rejected. Anyway, thanks for all the comments.

achot chavi · Feb 13, 2009

We've had excellent surveys, doubled census, low turnover, etc.
VERY IMPRESSIVE!!!
Whats your secret- you must be doing something right!!

travel50 · Feb 13, 2009

For starters, the staff and I were friends before I took the job (I had been there 6 yrs already), and only agreed to take it if they agreed to do it with me. We are quite simply, a team. Our census was so low that we were about to close. I told them that to avoid that and keep our jobs, we had to give the best care of any home in the county. We are a rural county, there are other homes here, and ours is the oldest building. So we give exceptional care. I argued with corporate until I got their pay increased by almost $2 an hour (aides and nurses). I help them on the floor when I can. We work very hard to keep our doctors happy. We have not had an in-house decub in over 3 yrs. When I took over, we also got a new administrator who is wonderful. The last one had been awful. I could go on as I am proud of our crew. Just guess it comes down to our being a team. There are always flies in the ointment, but mostly we do whatever we can to help the other one.

CapeCodMermaid, RN · Feb 14, 2009

You're so lucky to have a good team. I feel like a one woman show in my new building. I'm so tired of the 'that's not how we've always done it' and "that's not in my job description or union contract'..I could scream.

Here's a question: 96 year old woman...DNR...becomes lethargic after Ativan...one day lethargy. Goes to hospital for 'mental status changes" I wanted to keep her and give her some IV fluids..doc said no..send her. I get a report that she is hypernatremic with a UTI. Would you report this as a sentinel event?? Dehydration??? She's coming back to the facility CMO.

travel50 · Feb 14, 2009

Well, no I wouldn't report it. But then I wouldn't have had to send her to the hospital either. We have co-medical directors. They, along with their respective PA and NP, work very well with us. I know they want my opinion up front. If I don't give it, they ask. Matter of fact, when uncertain what one of my LPNs is saying / meaning after hours, it is not unheard of for one of them to call me at home to get my opinion / suggestion. So unless the family insisted, we would have held the ativan, lowered the dose for next time, or just dc'd it. We would have drawn some labs, stat if need be, and started an IV. Most of our people don't like to go to the hospital unless they absolutely have to. Why put a 96 yr old woman through the hassel of transport, change, the ER, etc., when it can be taken care of in house? Think I am with you on this one.

Our "team" is so good now that last week when I told our NP that I might be stepping down, she threw a pretend fit. I am 6 months shy of completing my master's, and am just so tired. Was thinking I should step down as the practicum is really going to be time consuming. The NP said to figure it out, the ADON can just step it up, anything. Said our team worked too well for me to mess it up. When I told her how tired I am at times, she offered lots of "drugs". (Said with a laugh, b/c we often beg for valium to get through the days). But no matter how tired I am, I do so appreciate having a great staff and great docs.